Organization
EYECARE SPECIALTIES OF CHARLESTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM FAULKNER (ADMINISTRATOR)
(843) 577-2047
Entity
Organization
Contact information
Practice address
3531 MARY ADER AVE STE B, CHARLESTON, SC 29414-5896
(843) 577-2047
Mailing address
3531 MARY ADER AVE STE B, CHARLESTON, SC 29414-5896
(843) 577-2047
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA9789
—
SC
Enumeration date
12/28/2005
Last updated
05/02/2019
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